Chiropractor guidelines

These guidelines should be read in conjunction with our General provider guidelines.

Who can provide chiropractic services?

You can provide services if you are registered under the Health Practitioner Regulation National Law (e.g. AHPRA) to practice in the chiropractic profession (other than as a student).

What we can pay for

We can pay the reasonable costs of your patient’s chiropractic treatment, without prior approval, immediately after a transport accident when it is required as a result of a transport accident injury.

We will review our client’s treatment to ensure it’s reasonable, clinically justified, outcome focused and in line with the Clinical Framework. We'll ask you and our client for information during these reviews and may temporarily stop funding treatment if we don’t receive it. When requested, you must complete the Allied health treatment and recovery plan and return it to us.

Reviews help us understand our client’s injuries, treatment needs and goals and how to best support them to get their life back on track. After a review we’ll let you and our client know the decision regarding further treatment.

Patient consultations

We can pay for:

  • chiropractic consultations, including lasers and dry needling techniques
  • out of rooms consultations – includes a travel fee for travel of less than 30 minutes

Radiology

We can pay for:

  • x-rays and radiological services provided by a licensed practitioner

Travel

We can pay for:

  • travel, when the client is medically unfit to travel (included as part of out of rooms consultation above)

Travel time can be paid for travel to and from your practice address and your patient's residence. Where more than one patient is visited in a single travel period, total travel costs should be apportioned equally between patients.

Exercise programs

We can pay for:

  • supervised exercise programs
  • monitoring and evaluating gym/swim programs

Equipment and orthoses

We can pay for:

Other things to note

For accidents that occurred prior to 14 February 2018 a medical excess may apply. Visit the medical excess page to see if it applies to your patient.  If the medical excess applies you will need to invoice the client directly.

As part of your patient’s treatment, you can complete Certificates of Capacity to assess and certify your patient’s capacity for work.

Gap in treatment

If our client has not received treatment in 6 months they will need to seek approval from us before we will pay for further treatment. Ask our client for a copy of their approval if you haven’t seen them in 6 months.

Patients with a severe injury

  • If your patient has a severe injury, the discussion, referral and approval of services may form part of the independence planning process between your patient's treating team and our TAC coordinator.
  • If your patient already has an individualised funding package, chiropractic services may be included as part of that.

How much we can pay

We can pay for services in line with our Chiropractic fees.

What we cannot pay for

We cannot pay for:

  • services that are included as part of a hospital inpatient bed fee
  • pool charges, such as pool hire and entry included in the hydrotherapy fee, aqua aerobics and swimming attire